Background: Although techniques with prosthetic meshes have improved results of inguinal hernia repair, the problem of recurrence remains. In addition to patient- and surgeon-related causes, protrusion of prosthetic mesh through the hernia defect can be considered as a factor of recurrence.
Methods: To simulate inguinal hernia, porcine tissue with standardized defects (3, 4, and 5 cm) was used. Nine different meshes (9 cm diameter) were positioned on the defects. In a pressure chamber the depth of protrusion through the defect was assessed. Both sides of each mesh were measured. Protrusion at a pressure representing Valsalva pressure was used for statistical analysis.
Results: Protrusion, including the incidence of collapse, increased with larger defect sizes. Significant protrusion differences were found between different meshes and occasionally between the 2 sides of the same mesh.
Conclusions: The differences between the effects of the various meshes emphasize the importance of material characteristics when developing new surgical techniques. The 3 meshes showing least protrusion are considered especially suitable when repairing large defects or when preferring a small mesh when repairing inguinal hernias with a preperitoneal sublay approach.